Provider Demographics
NPI:1922669290
Name:HEAVENLY HANDS HOME CARE SERVICES LLC
Entity Type:Organization
Organization Name:HEAVENLY HANDS HOME CARE SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ADMINISTRATOR
Authorized Official - Prefix:MISS
Authorized Official - First Name:SHAKIA
Authorized Official - Middle Name:ARIEL
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:757-771-3467
Mailing Address - Street 1:5215 COLLEY AVE STE 115
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23508-2166
Mailing Address - Country:US
Mailing Address - Phone:757-579-0547
Mailing Address - Fax:
Practice Address - Street 1:200 S KELLAM RD STE 200
Practice Address - Street 2:
Practice Address - City:VA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-3808
Practice Address - Country:US
Practice Address - Phone:757-771-3467
Practice Address - Fax:757-500-7704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-26
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Multi-Specialty